Phosphatidylcholine and the intestinal mucus layer: in vitro efficacy against Clostridium difficile -associated polymorphonuclear neutrophil activation

Abstract Background Phosphatidylcholine (PC), an important component of intestinal mucus, protects against Clostridium difficile toxin-induced intestinal barrier injury in vitro. Polymorphonuclear neutrophil (PMN) activation may contribute to intestinal injury and systemic toxicity in patients with...

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Bibliographic Details
Published in:The American journal of surgery 2015-03, Vol.209 (3), p.493-497
Main Authors: Olson, Alicia, M.D, Diebel, Lawrence N., M.D, Liberati, David M., M.S
Format: Article
Language:English
Subjects:
Blood
Chemotaxis
Clostridium
Clostridium difficile
Clostridium difficile - drug effects
Clostridium difficile - isolation & purification
Enterocolitis, Pseudomembranous - drug therapy
Enterocolitis, Pseudomembranous - microbiology
Enterocolitis, Pseudomembranous - pathology
Enzyme-Linked Immunosorbent Assay
HT29 Cells
Humans
Intestinal Mucosa - drug effects
Intestinal Mucosa - metabolism
Intestinal Mucosa - microbiology
Leukocytes
Mortality
Mucus - microbiology
Neutrophil Activation - drug effects
Phosphatidylcholine
Phosphatidylcholines - pharmacology
PMN activation
Standard deviation
Surgery
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Summary:Abstract Background Phosphatidylcholine (PC), an important component of intestinal mucus, protects against Clostridium difficile toxin-induced intestinal barrier injury in vitro. Polymorphonuclear neutrophil (PMN) activation may contribute to intestinal injury and systemic toxicity in patients with C. difficile -associated disease. We therefore hypothesized that the intestinal barrier function against C. difficile toxin by exogenous PC would ameliorate PMN activation. Methods Intestinal epithelial cell (IEC) monolayers were cocultured with C. difficile toxin A and/or exogenous PC. Naïve PMNs were cocultured with IEC culture supernatants and PMN activation, and chemotactic potential determined. Results PC treatment of IEC abrogated the enhanced PMN activation and chemotactic potential following toxin A exposure ( P < .001). Conclusions Exogenous PC ameliorated PMN activation from IECs exposed to C. difficile toxin. Administration of exogenous PC may be a useful adjunctive treatment in severely ill or immunocompromised patients with C. difficile- associated disease.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2014.10.012